Vascular injury during laparoscopic cholecystectomy

“Several risk factors may contribute to vascular injuries during laparoscopic cholecystectomy: Anatomical factors, including vascular anomalies, patient-related factors, the gallbladder pathology and surgeon’s experience. Concerning the anatomical factors, the different variants of vascular anatomy may represent a possible cause of bile duct injuries, particularly anomalies of the cystic artery and right hepatic artery (RHA). If surgeons are not aware of possible variations of the RHA, such as in the case of acute and chronic cholecystitis with unclear anatomy of Calot’s triangle, the RHA may be accidentally injured or mistaken for the cystic artery and actively cut off”

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Prevention of Parastomal Hernia

“Parastomal hernia, defined as an incisional hernia at the abdominal wall defect resulting from stoma formation, is a frequent complication of enterostomy (ileostomy and jejunostomy), colostomy, and urostomy. A growing body of evidence supports the use of prophylactic mesh at the time of stoma creation to prevent the development of PSH. In particular, the use of permanent mesh has been supported in the creation of an end colostomy, and prophylactic mesh has been studied for use in other types of stoma.”

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Laparoscopic mesh versus suture repair of hiatus hernia

“Hiatus hernia contributes to the pathophysiology of gastroesophageal reflux disease (GERD). Mesh-augmentation of surgical repair might be associated with a reduced risk of recurrence and GERD. However, recurrence rates, mesh-associated complications and quality of life after mesh versus suture repair are debated. The aim of this meta-analysis was to determine HH recurrence following mesh-augmentation versus suture repair.”

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Perioperative considerations for patients with epilepsy

“Epilepsy is the most common serious neurological disorder, with a prevalence of 0.5–1% of the population. Anaesthetists are frequently faced with patients with epilepsy undergoing
emergency or elective surgery and patients suffering seizures and status epilepticus in the intensive care unit (ICU).”

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Liver Transplantation in Acute-on-chronic Liver Failure

“Liver transplantation (LT) has revolutionized the treatment of cirrhotic patients. However, access to transplant is limited as demand for organs exceeds availability. Current allocation gives the highest priority to patients with the highest mortality risk. Hence, several
patients awaiting LT may deteriorate while waiting for LT.”

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Enhanced Recovery and Perioperative Quality Initiative on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway

“Perioperative malnutrition has proven to be challenging to define, diagnose, and treat. Despite these challenges, it is well known that sub-optimal nutritional status is a strong independent predictor of poor postoperative outcomes.”

“Malnourished surgical patients have significantly higher postoperative mortality, morbidity, length of stay (LOS), readmission rates, and increased hospital costs.It is estimated that 24%–65% of patients undergoing surgery are at nutrition risk. Additionally, recent prospective observational data indicate that undernourished patients or patients at risk of malnutrition are twice as likely to be readmitted within 30 days after elective colorectal surgery.”

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Immune-mediated inflammatory diseases and risk of venous thromboembolism:

“Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), affects ~10 million people worldwide every year, representing the third most
common cardiovascular disease globally. The 30-day case fatality rate after VTE diagnosis is 10.6%, with about 30% to 50% of survivors developing long-term complications that increase
the burden of this disease.”

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